|
BONE GRAFT SUBSTITUTE 2102-2201
|
Facility
|
IP
|
$5,548.00
|
|
|
Service Code
|
HCPCS C1762
|
| Hospital Charge Code |
5685829
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,827.26 |
| Max. Negotiated Rate |
$5,308.33 |
| Rate for Payer: Aetna Commercial |
$5,192.93
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$4,962.13
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,058.06
|
| Rate for Payer: Cash Price |
$1,664.40
|
| Rate for Payer: Cigna Commercial |
$5,308.33
|
| Rate for Payer: Health EOS Commercial |
$5,135.23
|
| Rate for Payer: HFN Commercial |
$5,308.33
|
| Rate for Payer: Multiplan Commercial |
$4,615.94
|
| Rate for Payer: Preferred Network Access Commercial |
$5,308.33
|
| Rate for Payer: Quartz Beloit One Network |
$2,827.26
|
| Rate for Payer: Quartz Commercial |
$3,461.95
|
| Rate for Payer: WEA Trust Commercial |
$3,173.46
|
| Rate for Payer: WPS Commercial |
$4,273.62
|
|
|
Bone Length Studies 77073
|
Professional
|
Both
|
$86.00
|
|
|
Service Code
|
CPT 77073
|
| Hospital Charge Code |
5482710
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$39.35 |
| Max. Negotiated Rate |
$229.74 |
| Rate for Payer: Aetna Commercial |
$84.97
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$76.92
|
| Rate for Payer: Aetna Managed Medicare |
$45.95
|
| Rate for Payer: Anthem Medicare Advantage |
$45.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$45.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$45.95
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cigna Commercial |
$84.97
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$44.72
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$45.95
|
| Rate for Payer: Health EOS Commercial |
$81.39
|
| Rate for Payer: HFN Commercial |
$84.97
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$158.75
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$158.75
|
| Rate for Payer: Independent Care Health Plan Medicare |
$45.95
|
| Rate for Payer: Multiplan Commercial |
$71.55
|
| Rate for Payer: NAPHCARE Commercial |
$68.92
|
| Rate for Payer: Preferred Network Access Commercial |
$84.97
|
| Rate for Payer: Quartz Beloit One Network |
$39.35
|
| Rate for Payer: Quartz Commercial |
$50.98
|
| Rate for Payer: Quartz Medicare Advantage |
$45.95
|
| Rate for Payer: The Alliance Commercial |
$174.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$45.95
|
| Rate for Payer: WEA Trust Commercial |
$49.19
|
| Rate for Payer: WPS Commercial |
$229.74
|
|
|
Bone Marrow, Aspiration Only
|
Professional
|
Both
|
$605.00
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
1190866
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$54.91 |
| Max. Negotiated Rate |
$597.74 |
| Rate for Payer: Aetna Commercial |
$597.74
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$541.11
|
| Rate for Payer: Aetna Managed Medicare |
$54.91
|
| Rate for Payer: Anthem Medicare Advantage |
$54.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$54.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$54.91
|
| Rate for Payer: Cash Price |
$181.50
|
| Rate for Payer: Cash Price |
$181.50
|
| Rate for Payer: Cash Price |
$181.50
|
| Rate for Payer: Cigna Commercial |
$597.74
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$143.19
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$54.91
|
| Rate for Payer: Health EOS Commercial |
$572.57
|
| Rate for Payer: HFN Commercial |
$597.74
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$239.80
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$239.80
|
| Rate for Payer: Independent Care Health Plan Medicare |
$54.91
|
| Rate for Payer: Multiplan Commercial |
$503.36
|
| Rate for Payer: NAPHCARE Commercial |
$82.37
|
| Rate for Payer: Preferred Network Access Commercial |
$597.74
|
| Rate for Payer: Quartz Beloit One Network |
$276.85
|
| Rate for Payer: Quartz Commercial |
$358.64
|
| Rate for Payer: Quartz Medicare Advantage |
$54.91
|
| Rate for Payer: The Alliance Commercial |
$233.38
|
| Rate for Payer: United Healthcare Medicaid |
$143.19
|
| Rate for Payer: United Healthcare Medicare Advantage |
$54.91
|
| Rate for Payer: WEA Trust Commercial |
$346.06
|
| Rate for Payer: WPS Commercial |
$247.10
|
|
|
BONE MARROW BIOPSIES
|
Facility
|
OP
|
$361.64
|
|
|
Service Code
|
EAPG 00124
|
| Min. Negotiated Rate |
$347.73 |
| Max. Negotiated Rate |
$361.64 |
| Rate for Payer: Anthem Medicaid |
$347.73
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicaid HMO |
$347.73
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$347.73
|
| Rate for Payer: Dean Health Medicaid |
$347.73
|
| Rate for Payer: Independent Care Health Plan Medicaid |
$347.73
|
| Rate for Payer: Managed Health Services Medicaid |
$361.64
|
| Rate for Payer: Molina Healthcare Medicaid |
$347.73
|
| Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP |
$347.73
|
| Rate for Payer: United Healthcare Medicaid |
$347.73
|
|
|
Bone Marrow Biopsy
|
Facility
|
IP
|
$589.00
|
|
|
Service Code
|
CPT 38222 TC
|
| Hospital Charge Code |
6230725
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$300.15 |
| Max. Negotiated Rate |
$563.56 |
| Rate for Payer: Aetna Commercial |
$551.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$526.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$324.66
|
| Rate for Payer: Cash Price |
$176.70
|
| Rate for Payer: Cigna Commercial |
$563.56
|
| Rate for Payer: Health EOS Commercial |
$545.18
|
| Rate for Payer: HFN Commercial |
$563.56
|
| Rate for Payer: Multiplan Commercial |
$490.05
|
| Rate for Payer: Preferred Network Access Commercial |
$563.56
|
| Rate for Payer: Quartz Beloit One Network |
$300.15
|
| Rate for Payer: Quartz Commercial |
$367.54
|
| Rate for Payer: WEA Trust Commercial |
$336.91
|
| Rate for Payer: WPS Commercial |
$453.71
|
|
|
Bone Marrow Biopsy
|
Professional
|
Both
|
$589.00
|
|
|
Service Code
|
CPT 38222 TC
|
| Hospital Charge Code |
6230725
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$138.03 |
| Max. Negotiated Rate |
$581.93 |
| Rate for Payer: Aetna Commercial |
$581.93
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$526.80
|
| Rate for Payer: Cash Price |
$176.70
|
| Rate for Payer: Cash Price |
$176.70
|
| Rate for Payer: Cash Price |
$176.70
|
| Rate for Payer: Cigna Commercial |
$581.93
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$138.03
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$367.54
|
| Rate for Payer: Health EOS Commercial |
$557.43
|
| Rate for Payer: HFN Commercial |
$581.93
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$271.89
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$271.89
|
| Rate for Payer: Multiplan Commercial |
$490.05
|
| Rate for Payer: Preferred Network Access Commercial |
$581.93
|
| Rate for Payer: Quartz Beloit One Network |
$269.53
|
| Rate for Payer: Quartz Commercial |
$349.16
|
| Rate for Payer: The Alliance Commercial |
$306.28
|
| Rate for Payer: United Healthcare Medicaid |
$138.03
|
| Rate for Payer: WEA Trust Commercial |
$336.91
|
| Rate for Payer: WPS Commercial |
$453.71
|
|
|
Bone Marrow Biopsy
|
Facility
|
OP
|
$589.00
|
|
|
Service Code
|
CPT 38222 TC
|
| Hospital Charge Code |
6230725
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$171.52 |
| Max. Negotiated Rate |
$4,386.95 |
| Rate for Payer: Aetna Commercial |
$551.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$526.80
|
| Rate for Payer: Aetna Managed Medicare |
$171.52
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$3,333.20
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$2,689.44
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,552.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$324.66
|
| Rate for Payer: Cash Price |
$176.70
|
| Rate for Payer: Cash Price |
$176.70
|
| Rate for Payer: Cash Price |
$176.70
|
| Rate for Payer: Cash Price |
$176.70
|
| Rate for Payer: Cigna Commercial |
$563.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,386.95
|
| Rate for Payer: Health EOS Commercial |
$545.18
|
| Rate for Payer: HFN Commercial |
$563.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$459.42
|
| Rate for Payer: Multiplan Commercial |
$490.05
|
| Rate for Payer: NAPHCARE Commercial |
$367.54
|
| Rate for Payer: Preferred Network Access Commercial |
$563.56
|
| Rate for Payer: Quartz Beloit One Network |
$300.15
|
| Rate for Payer: Quartz Commercial |
$398.16
|
| Rate for Payer: Quartz Medicare Advantage |
$367.54
|
| Rate for Payer: The Alliance Commercial |
$306.28
|
| Rate for Payer: United Healthcare PPO |
$2,147.60
|
| Rate for Payer: WEA Trust Commercial |
$336.91
|
| Rate for Payer: WPS Commercial |
$453.71
|
|
|
Bone Marrow Biopsy and Aspiration 38222
|
Professional
|
Both
|
$1,273.00
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
5383338
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$61.34 |
| Max. Negotiated Rate |
$1,257.72 |
| Rate for Payer: Aetna Commercial |
$1,257.72
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$1,138.57
|
| Rate for Payer: Aetna Managed Medicare |
$61.34
|
| Rate for Payer: Anthem Medicare Advantage |
$61.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$61.34
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$61.34
|
| Rate for Payer: Cash Price |
$381.90
|
| Rate for Payer: Cash Price |
$381.90
|
| Rate for Payer: Cash Price |
$381.90
|
| Rate for Payer: Cigna Commercial |
$1,257.72
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$138.03
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$61.34
|
| Rate for Payer: Health EOS Commercial |
$1,204.77
|
| Rate for Payer: HFN Commercial |
$1,257.72
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$271.89
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$271.89
|
| Rate for Payer: Independent Care Health Plan Medicare |
$61.34
|
| Rate for Payer: Multiplan Commercial |
$1,059.14
|
| Rate for Payer: NAPHCARE Commercial |
$92.01
|
| Rate for Payer: Preferred Network Access Commercial |
$1,257.72
|
| Rate for Payer: Quartz Beloit One Network |
$582.52
|
| Rate for Payer: Quartz Commercial |
$754.63
|
| Rate for Payer: Quartz Medicare Advantage |
$61.34
|
| Rate for Payer: The Alliance Commercial |
$260.69
|
| Rate for Payer: United Healthcare Medicaid |
$138.03
|
| Rate for Payer: United Healthcare Medicare Advantage |
$61.34
|
| Rate for Payer: WEA Trust Commercial |
$728.16
|
| Rate for Payer: WPS Commercial |
$276.03
|
|
|
Bone Marrow Bipsy, Needle or Trocar
|
Professional
|
Both
|
$842.00
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
1190865
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$56.91 |
| Max. Negotiated Rate |
$831.90 |
| Rate for Payer: Aetna Commercial |
$831.90
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$753.08
|
| Rate for Payer: Aetna Managed Medicare |
$56.91
|
| Rate for Payer: Anthem Medicare Advantage |
$56.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$56.91
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$56.91
|
| Rate for Payer: Cash Price |
$252.60
|
| Rate for Payer: Cash Price |
$252.60
|
| Rate for Payer: Cash Price |
$252.60
|
| Rate for Payer: Cigna Commercial |
$831.90
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$159.21
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$56.91
|
| Rate for Payer: Health EOS Commercial |
$796.87
|
| Rate for Payer: HFN Commercial |
$831.90
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$247.03
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$247.03
|
| Rate for Payer: Independent Care Health Plan Medicare |
$56.91
|
| Rate for Payer: Multiplan Commercial |
$700.54
|
| Rate for Payer: NAPHCARE Commercial |
$85.36
|
| Rate for Payer: Preferred Network Access Commercial |
$831.90
|
| Rate for Payer: Quartz Beloit One Network |
$385.30
|
| Rate for Payer: Quartz Commercial |
$499.14
|
| Rate for Payer: Quartz Medicare Advantage |
$56.91
|
| Rate for Payer: The Alliance Commercial |
$241.86
|
| Rate for Payer: United Healthcare Medicaid |
$159.21
|
| Rate for Payer: United Healthcare Medicare Advantage |
$56.91
|
| Rate for Payer: WEA Trust Commercial |
$481.62
|
| Rate for Payer: WPS Commercial |
$256.09
|
|
|
Bone Marrow Complete Analysis to Mayo
|
Facility
|
IP
|
$260.00
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
1038802
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$132.50 |
| Max. Negotiated Rate |
$248.77 |
| Rate for Payer: Aetna Commercial |
$243.36
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$232.54
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$143.31
|
| Rate for Payer: Cash Price |
$78.00
|
| Rate for Payer: Cigna Commercial |
$248.77
|
| Rate for Payer: Health EOS Commercial |
$240.66
|
| Rate for Payer: HFN Commercial |
$248.77
|
| Rate for Payer: Multiplan Commercial |
$216.32
|
| Rate for Payer: Preferred Network Access Commercial |
$248.77
|
| Rate for Payer: Quartz Beloit One Network |
$132.50
|
| Rate for Payer: Quartz Commercial |
$162.24
|
| Rate for Payer: WEA Trust Commercial |
$148.72
|
| Rate for Payer: WPS Commercial |
$200.28
|
|
|
Bone Marrow Complete Analysis to Mayo
|
Facility
|
OP
|
$260.00
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
1038802
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$54.84 |
| Max. Negotiated Rate |
$248.77 |
| Rate for Payer: Aetna Commercial |
$243.36
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$232.54
|
| Rate for Payer: Aetna Managed Medicare |
$54.84
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$208.88
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$97.48
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$92.47
|
| Rate for Payer: Anthem Medicare Advantage |
$54.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$143.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$54.84
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$54.84
|
| Rate for Payer: Cash Price |
$78.00
|
| Rate for Payer: Cash Price |
$78.00
|
| Rate for Payer: Cigna Commercial |
$248.77
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$54.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$151.32
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$54.84
|
| Rate for Payer: Health EOS Commercial |
$240.66
|
| Rate for Payer: HFN Commercial |
$248.77
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$204.00
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$54.84
|
| Rate for Payer: Independent Care Health Plan Medicare |
$54.84
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$54.84
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$54.84
|
| Rate for Payer: Multiplan Commercial |
$216.32
|
| Rate for Payer: NAPHCARE Commercial |
$82.26
|
| Rate for Payer: Preferred Network Access Commercial |
$248.77
|
| Rate for Payer: Quartz Beloit One Network |
$132.50
|
| Rate for Payer: Quartz Commercial |
$175.76
|
| Rate for Payer: Quartz Medicare Advantage |
$54.84
|
| Rate for Payer: The Alliance Commercial |
$219.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$54.84
|
| Rate for Payer: United Healthcare PPO |
$202.80
|
| Rate for Payer: WEA Trust Commercial |
$148.72
|
| Rate for Payer: Wellcare Medicare |
$54.84
|
| Rate for Payer: WPS Commercial |
$200.28
|
|
|
Bone Marrow Complete Analysis to Mayo
|
Professional
|
Both
|
$260.00
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
1038802
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$36.08 |
| Max. Negotiated Rate |
$310.21 |
| Rate for Payer: Aetna Commercial |
$256.88
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$232.54
|
| Rate for Payer: Aetna Managed Medicare |
$70.50
|
| Rate for Payer: Anthem Commercial |
$36.08
|
| Rate for Payer: Anthem Medicare Advantage |
$70.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$70.50
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$70.50
|
| Rate for Payer: Cash Price |
$78.00
|
| Rate for Payer: Cash Price |
$78.00
|
| Rate for Payer: Cigna Commercial |
$256.88
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$135.20
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$70.50
|
| Rate for Payer: Health EOS Commercial |
$246.06
|
| Rate for Payer: HFN Commercial |
$256.88
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$251.30
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$251.30
|
| Rate for Payer: Independent Care Health Plan Medicare |
$70.50
|
| Rate for Payer: Multiplan Commercial |
$216.32
|
| Rate for Payer: NAPHCARE Commercial |
$105.75
|
| Rate for Payer: Preferred Network Access Commercial |
$256.88
|
| Rate for Payer: Quartz Beloit One Network |
$118.98
|
| Rate for Payer: Quartz Commercial |
$154.13
|
| Rate for Payer: Quartz Medicare Advantage |
$70.50
|
| Rate for Payer: The Alliance Commercial |
$278.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$70.50
|
| Rate for Payer: WEA Trust Commercial |
$148.72
|
| Rate for Payer: WPS Commercial |
$310.21
|
|
|
Bone Marrow Decalcification
|
Facility
|
IP
|
$55.00
|
|
|
Service Code
|
CPT 88311
|
| Hospital Charge Code |
5543212
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$28.03 |
| Max. Negotiated Rate |
$52.62 |
| Rate for Payer: Aetna Commercial |
$51.48
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$49.19
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$30.32
|
| Rate for Payer: Cash Price |
$16.50
|
| Rate for Payer: Cigna Commercial |
$52.62
|
| Rate for Payer: Health EOS Commercial |
$50.91
|
| Rate for Payer: HFN Commercial |
$52.62
|
| Rate for Payer: Multiplan Commercial |
$45.76
|
| Rate for Payer: Preferred Network Access Commercial |
$52.62
|
| Rate for Payer: Quartz Beloit One Network |
$28.03
|
| Rate for Payer: Quartz Commercial |
$34.32
|
| Rate for Payer: WEA Trust Commercial |
$31.46
|
| Rate for Payer: WPS Commercial |
$42.37
|
|
|
Bone Marrow Decalcification
|
Professional
|
Both
|
$55.00
|
|
|
Service Code
|
CPT 88311
|
| Hospital Charge Code |
5543212
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.54 |
| Max. Negotiated Rate |
$85.89 |
| Rate for Payer: Aetna Commercial |
$54.34
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$49.19
|
| Rate for Payer: Aetna Managed Medicare |
$19.52
|
| Rate for Payer: Anthem Commercial |
$11.54
|
| Rate for Payer: Anthem Medicare Advantage |
$19.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$19.52
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$19.52
|
| Rate for Payer: Cash Price |
$16.50
|
| Rate for Payer: Cash Price |
$16.50
|
| Rate for Payer: Cigna Commercial |
$54.34
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$28.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$19.52
|
| Rate for Payer: Health EOS Commercial |
$52.05
|
| Rate for Payer: HFN Commercial |
$54.34
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$73.76
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$73.76
|
| Rate for Payer: Independent Care Health Plan Medicare |
$19.52
|
| Rate for Payer: Multiplan Commercial |
$45.76
|
| Rate for Payer: NAPHCARE Commercial |
$29.28
|
| Rate for Payer: Preferred Network Access Commercial |
$54.34
|
| Rate for Payer: Quartz Beloit One Network |
$25.17
|
| Rate for Payer: Quartz Commercial |
$32.60
|
| Rate for Payer: Quartz Medicare Advantage |
$19.52
|
| Rate for Payer: The Alliance Commercial |
$77.11
|
| Rate for Payer: United Healthcare Medicare Advantage |
$19.52
|
| Rate for Payer: WEA Trust Commercial |
$31.46
|
| Rate for Payer: WPS Commercial |
$85.89
|
|
|
Bone Marrow Decalcification
|
Facility
|
OP
|
$55.00
|
|
|
Service Code
|
CPT 88311
|
| Hospital Charge Code |
5543212
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.02 |
| Max. Negotiated Rate |
$78.08 |
| Rate for Payer: Aetna Commercial |
$51.48
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$49.19
|
| Rate for Payer: Aetna Managed Medicare |
$16.02
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$37.18
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$28.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$27.46
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$30.32
|
| Rate for Payer: Cash Price |
$16.50
|
| Rate for Payer: Cash Price |
$16.50
|
| Rate for Payer: Cigna Commercial |
$52.62
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$32.01
|
| Rate for Payer: Health EOS Commercial |
$50.91
|
| Rate for Payer: HFN Commercial |
$52.62
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$42.90
|
| Rate for Payer: Multiplan Commercial |
$45.76
|
| Rate for Payer: NAPHCARE Commercial |
$34.32
|
| Rate for Payer: Preferred Network Access Commercial |
$52.62
|
| Rate for Payer: Quartz Beloit One Network |
$28.03
|
| Rate for Payer: Quartz Commercial |
$37.18
|
| Rate for Payer: Quartz Medicare Advantage |
$34.32
|
| Rate for Payer: The Alliance Commercial |
$78.08
|
| Rate for Payer: United Healthcare PPO |
$42.90
|
| Rate for Payer: WEA Trust Commercial |
$31.46
|
| Rate for Payer: WPS Commercial |
$42.37
|
|
|
BONE MARROW HARVEST TRANSPLANTATION AUTOLOGOUS 38232
|
Professional
|
Both
|
$3,028.00
|
|
|
Service Code
|
CPT 38232
|
| Hospital Charge Code |
6170067
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$142.08 |
| Max. Negotiated Rate |
$2,991.66 |
| Rate for Payer: Aetna Commercial |
$2,991.66
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$2,708.24
|
| Rate for Payer: Aetna Managed Medicare |
$152.21
|
| Rate for Payer: Anthem Medicare Advantage |
$152.21
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$152.21
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$152.21
|
| Rate for Payer: Cash Price |
$908.40
|
| Rate for Payer: Cash Price |
$908.40
|
| Rate for Payer: Cash Price |
$908.40
|
| Rate for Payer: Cigna Commercial |
$2,991.66
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$142.08
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$152.21
|
| Rate for Payer: Health EOS Commercial |
$2,865.70
|
| Rate for Payer: HFN Commercial |
$2,991.66
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$681.89
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$681.89
|
| Rate for Payer: Independent Care Health Plan Medicare |
$152.21
|
| Rate for Payer: Multiplan Commercial |
$2,519.30
|
| Rate for Payer: NAPHCARE Commercial |
$228.32
|
| Rate for Payer: Preferred Network Access Commercial |
$2,991.66
|
| Rate for Payer: Quartz Beloit One Network |
$1,385.61
|
| Rate for Payer: Quartz Commercial |
$1,795.00
|
| Rate for Payer: Quartz Medicare Advantage |
$152.21
|
| Rate for Payer: The Alliance Commercial |
$646.91
|
| Rate for Payer: United Healthcare Medicaid |
$142.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$152.21
|
| Rate for Payer: WEA Trust Commercial |
$1,732.02
|
| Rate for Payer: WPS Commercial |
$684.96
|
|
|
Bone Marrow Peripheral Blood
|
Facility
|
OP
|
$330.00
|
|
|
Service Code
|
CPT 85060
|
| Hospital Charge Code |
5543210
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$76.63 |
| Max. Negotiated Rate |
$315.74 |
| Rate for Payer: Aetna Commercial |
$308.88
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$295.15
|
| Rate for Payer: Aetna Managed Medicare |
$96.10
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$223.08
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$171.60
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$164.74
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$181.90
|
| Rate for Payer: Cash Price |
$99.00
|
| Rate for Payer: Cash Price |
$99.00
|
| Rate for Payer: Cigna Commercial |
$315.74
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$192.06
|
| Rate for Payer: Health EOS Commercial |
$305.45
|
| Rate for Payer: HFN Commercial |
$315.74
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$257.40
|
| Rate for Payer: Multiplan Commercial |
$274.56
|
| Rate for Payer: NAPHCARE Commercial |
$205.92
|
| Rate for Payer: Preferred Network Access Commercial |
$315.74
|
| Rate for Payer: Quartz Beloit One Network |
$168.17
|
| Rate for Payer: Quartz Commercial |
$223.08
|
| Rate for Payer: Quartz Medicare Advantage |
$205.92
|
| Rate for Payer: The Alliance Commercial |
$76.63
|
| Rate for Payer: United Healthcare PPO |
$257.40
|
| Rate for Payer: WEA Trust Commercial |
$188.76
|
| Rate for Payer: WPS Commercial |
$254.20
|
|
|
Bone Marrow Peripheral Blood
|
Facility
|
IP
|
$330.00
|
|
|
Service Code
|
CPT 85060
|
| Hospital Charge Code |
5543210
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$168.17 |
| Max. Negotiated Rate |
$315.74 |
| Rate for Payer: Aetna Commercial |
$308.88
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$295.15
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$181.90
|
| Rate for Payer: Cash Price |
$99.00
|
| Rate for Payer: Cigna Commercial |
$315.74
|
| Rate for Payer: Health EOS Commercial |
$305.45
|
| Rate for Payer: HFN Commercial |
$315.74
|
| Rate for Payer: Multiplan Commercial |
$274.56
|
| Rate for Payer: Preferred Network Access Commercial |
$315.74
|
| Rate for Payer: Quartz Beloit One Network |
$168.17
|
| Rate for Payer: Quartz Commercial |
$205.92
|
| Rate for Payer: WEA Trust Commercial |
$188.76
|
| Rate for Payer: WPS Commercial |
$254.20
|
|
|
Bone Marrow Peripheral Blood
|
Professional
|
Both
|
$330.00
|
|
|
Service Code
|
CPT 85060
|
| Hospital Charge Code |
5543210
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$19.16 |
| Max. Negotiated Rate |
$326.04 |
| Rate for Payer: Aetna Commercial |
$326.04
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$295.15
|
| Rate for Payer: Aetna Managed Medicare |
$19.16
|
| Rate for Payer: Anthem Commercial |
$22.37
|
| Rate for Payer: Anthem Medicare Advantage |
$19.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$19.16
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$19.16
|
| Rate for Payer: Cash Price |
$99.00
|
| Rate for Payer: Cash Price |
$99.00
|
| Rate for Payer: Cigna Commercial |
$326.04
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$171.60
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$19.16
|
| Rate for Payer: Health EOS Commercial |
$312.31
|
| Rate for Payer: HFN Commercial |
$326.04
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$85.73
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$85.73
|
| Rate for Payer: Independent Care Health Plan Medicare |
$19.16
|
| Rate for Payer: Multiplan Commercial |
$274.56
|
| Rate for Payer: NAPHCARE Commercial |
$28.74
|
| Rate for Payer: Preferred Network Access Commercial |
$326.04
|
| Rate for Payer: Quartz Beloit One Network |
$151.01
|
| Rate for Payer: Quartz Commercial |
$195.62
|
| Rate for Payer: Quartz Medicare Advantage |
$19.16
|
| Rate for Payer: The Alliance Commercial |
$75.67
|
| Rate for Payer: United Healthcare Medicare Advantage |
$19.16
|
| Rate for Payer: WEA Trust Commercial |
$188.76
|
| Rate for Payer: WPS Commercial |
$84.29
|
|
|
Bone Marrow Peripheral Blood, TC
|
Facility
|
OP
|
$45.00
|
|
|
Service Code
|
CPT 85007
|
| Hospital Charge Code |
5543211
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.95 |
| Max. Negotiated Rate |
$43.06 |
| Rate for Payer: Aetna Commercial |
$42.12
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$40.25
|
| Rate for Payer: Aetna Managed Medicare |
$3.95
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$14.82
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$6.92
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$6.56
|
| Rate for Payer: Anthem Medicare Advantage |
$3.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$24.80
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3.95
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cigna Commercial |
$43.06
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3.95
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$26.19
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3.95
|
| Rate for Payer: Health EOS Commercial |
$41.65
|
| Rate for Payer: HFN Commercial |
$43.06
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$14.70
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3.95
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3.95
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3.95
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3.95
|
| Rate for Payer: Multiplan Commercial |
$37.44
|
| Rate for Payer: NAPHCARE Commercial |
$5.93
|
| Rate for Payer: Preferred Network Access Commercial |
$43.06
|
| Rate for Payer: Quartz Beloit One Network |
$22.93
|
| Rate for Payer: Quartz Commercial |
$30.42
|
| Rate for Payer: Quartz Medicare Advantage |
$3.95
|
| Rate for Payer: The Alliance Commercial |
$15.81
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3.95
|
| Rate for Payer: United Healthcare PPO |
$35.10
|
| Rate for Payer: WEA Trust Commercial |
$25.74
|
| Rate for Payer: Wellcare Medicare |
$3.95
|
| Rate for Payer: WPS Commercial |
$34.66
|
|
|
Bone Marrow Peripheral Blood, TC
|
Facility
|
IP
|
$45.00
|
|
|
Service Code
|
CPT 85007
|
| Hospital Charge Code |
5543211
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.93 |
| Max. Negotiated Rate |
$43.06 |
| Rate for Payer: Aetna Commercial |
$42.12
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$40.25
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$24.80
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cigna Commercial |
$43.06
|
| Rate for Payer: Health EOS Commercial |
$41.65
|
| Rate for Payer: HFN Commercial |
$43.06
|
| Rate for Payer: Multiplan Commercial |
$37.44
|
| Rate for Payer: Preferred Network Access Commercial |
$43.06
|
| Rate for Payer: Quartz Beloit One Network |
$22.93
|
| Rate for Payer: Quartz Commercial |
$28.08
|
| Rate for Payer: WEA Trust Commercial |
$25.74
|
| Rate for Payer: WPS Commercial |
$34.66
|
|
|
Bone Marrow Peripheral Blood, TC
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
CPT 85007
|
| Hospital Charge Code |
5543211
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.95 |
| Max. Negotiated Rate |
$44.46 |
| Rate for Payer: Aetna Commercial |
$44.46
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$40.25
|
| Rate for Payer: Aetna Managed Medicare |
$3.95
|
| Rate for Payer: Anthem Medicare Advantage |
$3.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3.95
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3.95
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cigna Commercial |
$44.46
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid |
$23.40
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3.95
|
| Rate for Payer: Health EOS Commercial |
$42.59
|
| Rate for Payer: HFN Commercial |
$44.46
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$13.95
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13.95
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3.95
|
| Rate for Payer: Multiplan Commercial |
$37.44
|
| Rate for Payer: NAPHCARE Commercial |
$5.93
|
| Rate for Payer: Preferred Network Access Commercial |
$44.46
|
| Rate for Payer: Quartz Beloit One Network |
$20.59
|
| Rate for Payer: Quartz Commercial |
$26.68
|
| Rate for Payer: Quartz Medicare Advantage |
$3.95
|
| Rate for Payer: The Alliance Commercial |
$15.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3.95
|
| Rate for Payer: WEA Trust Commercial |
$25.74
|
| Rate for Payer: WPS Commercial |
$17.39
|
|
|
BONE MATRIX BIO4 10CC 3102-2110
|
Facility
|
IP
|
$26,185.00
|
|
|
Service Code
|
HCPCS C1762
|
| Hospital Charge Code |
5685698
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13,343.88 |
| Max. Negotiated Rate |
$25,053.81 |
| Rate for Payer: Aetna Commercial |
$24,509.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$23,419.86
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$14,433.17
|
| Rate for Payer: Cash Price |
$7,855.50
|
| Rate for Payer: Cigna Commercial |
$25,053.81
|
| Rate for Payer: Health EOS Commercial |
$24,236.84
|
| Rate for Payer: HFN Commercial |
$25,053.81
|
| Rate for Payer: Multiplan Commercial |
$21,785.92
|
| Rate for Payer: Preferred Network Access Commercial |
$25,053.81
|
| Rate for Payer: Quartz Beloit One Network |
$13,343.88
|
| Rate for Payer: Quartz Commercial |
$16,339.44
|
| Rate for Payer: WEA Trust Commercial |
$14,977.82
|
| Rate for Payer: WPS Commercial |
$20,170.31
|
|
|
BONE MATRIX BIO4 10CC 3102-2110
|
Facility
|
OP
|
$26,185.00
|
|
|
Service Code
|
HCPCS C1762
|
| Hospital Charge Code |
5685698
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,625.07 |
| Max. Negotiated Rate |
$25,053.81 |
| Rate for Payer: Aetna Commercial |
$24,509.16
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$23,419.86
|
| Rate for Payer: Aetna Managed Medicare |
$7,625.07
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$17,701.06
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$13,616.20
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$13,071.55
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$14,433.17
|
| Rate for Payer: Cash Price |
$7,855.50
|
| Rate for Payer: Cigna Commercial |
$25,053.81
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$15,239.67
|
| Rate for Payer: Health EOS Commercial |
$24,236.84
|
| Rate for Payer: HFN Commercial |
$25,053.81
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$20,424.30
|
| Rate for Payer: Multiplan Commercial |
$21,785.92
|
| Rate for Payer: NAPHCARE Commercial |
$16,339.44
|
| Rate for Payer: Preferred Network Access Commercial |
$25,053.81
|
| Rate for Payer: Quartz Beloit One Network |
$13,343.88
|
| Rate for Payer: Quartz Commercial |
$17,701.06
|
| Rate for Payer: Quartz Medicare Advantage |
$16,339.44
|
| Rate for Payer: The Alliance Commercial |
$13,616.20
|
| Rate for Payer: WEA Trust Commercial |
$14,977.82
|
| Rate for Payer: WPS Commercial |
$20,170.31
|
|
|
BONE MATRIX BIO4 1CC 3102-2101
|
Facility
|
OP
|
$5,983.00
|
|
|
Service Code
|
HCPCS C1762
|
| Hospital Charge Code |
5685695
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,742.25 |
| Max. Negotiated Rate |
$5,724.53 |
| Rate for Payer: Aetna Commercial |
$5,600.09
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$5,351.20
|
| Rate for Payer: Aetna Managed Medicare |
$1,742.25
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,044.51
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,111.16
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$2,986.71
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$3,297.83
|
| Rate for Payer: Cash Price |
$1,794.90
|
| Rate for Payer: Cigna Commercial |
$5,724.53
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$3,482.11
|
| Rate for Payer: Health EOS Commercial |
$5,537.86
|
| Rate for Payer: HFN Commercial |
$5,724.53
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$4,666.74
|
| Rate for Payer: Multiplan Commercial |
$4,977.86
|
| Rate for Payer: NAPHCARE Commercial |
$3,733.39
|
| Rate for Payer: Preferred Network Access Commercial |
$5,724.53
|
| Rate for Payer: Quartz Beloit One Network |
$3,048.94
|
| Rate for Payer: Quartz Commercial |
$4,044.51
|
| Rate for Payer: Quartz Medicare Advantage |
$3,733.39
|
| Rate for Payer: The Alliance Commercial |
$3,111.16
|
| Rate for Payer: WEA Trust Commercial |
$3,422.28
|
| Rate for Payer: WPS Commercial |
$4,608.70
|
|
